needle poking feeling in throat


 Needle poking feeling in throat may happen because of the following reasons:

  • Glossopharyngeal neuralgia
  • Allergies


  • Stomach acid return or GERD
  • Pharyngitis
  • Otitis media
  • Cervical discopathy
  • Cervical muscle spasms
  • Thyroiditis
  • Pharynx disorders
  • Vocal cord tumors
  • Lymphadenopathy

Considering that there are many other factors that may cause needle feeling in throat but they are rare.

In the following you will get some medical clue to find out the most probable cause for your problem and tips to get rid of it.


What you will read next:

General considerations

Glossopharyngeal neuralgia


Stomach acid return or GERD


Otitis media

Cervical discopathy

Cervical muscle spasms


Pharynx disorders

Vocal cord tumors


Take away



 General considerations

Feeling discomfort and needle poking pain in throat is a common complaint that one will have in many different circumstances. Among the different causes that can provoke this sensation, some are very common like simple pharyngitis and some are very rare like cervical masses and glossopharyngeal neuralgia.

Later in this caption we will describe in detail some of these causes that you may not find enough about them elsewhere.


Glossopharyngeal neuralgia

  • What is Glossopharyngeal neuralgia?

If you are suffering from needle poking in the throat area and want to know the cause of this annoying feeling in the throat, you are in right place.

In the following, we will discuss the pain attacks in throat, which is caused by condition medically name as Glossopharyngeal neuralgia.

This disorder can cause annoying pain and needle poking in the throat.

Glossopharyngeal neuralgia is a rare disorder in the function of the ninth pair of nerves in the brain, the lingual-pharyngeal nerve or the glossopharyngeal nerve.

We have 12 pair of nerves that emerges from brain and each has its own unique function. The ninth pair is responsible for sensation and muscle movements near throat.

Tenth pair, Vagus nerve, is responsible for lots of functions including heart beat regulation and digestive system movements.

The pain in glossopharyngeal neuralgia has the following characteristics:

  • It begins suddenly and resolve spontaneously
  • Sometimes provoked by chewing, talking or eating
  • May associated with heart beat problems
  • There is no pain between attacks
  • The pain is needle like and sharp shooting characteristics

If you don’t experience any of the above mentioned criteria with your feeling in your throat, glossopharyngeal neuralgia may not be a good reason for your problem.

There is nothing to worry in this disorder and almost always it resolves completely and spontaneously without any long lasting adverse effects except the consideration must be made about accompanying heart problems.

Because the pharyngeal nerve and the Vagus nerve are anatomically close to each other, in rare cases the development of glossopharyngeal neuralgia can simultaneously stimulate the Vagus nerve.

If this nerve is stimulated, it is associated with a decrease in heart rate.

Therefore, if stimulation occurs simultaneously in the pharyngeal and Vagus nerves, the person may experience a sharp drop in heart rate and even heart failure in addition to the annoying sore throat.

Attacking pain in the throat, which is a rare disorder, and in this disorder, like other types of neuralgia, there will be sharp and sharp shooting attacks for only a few seconds.

A person with glossopharyngeal neuralgia, will not feel pain between the attacks of the throat.

The pain of this neuralgia starts around the ear, after the pain starts, it spreads to the end of the tongue, the surrounding tonsils, the lower jaw and even the neck.

  • Epidemiology

The prevalence of this disorder estimated to be approximately 0.7 per 100,000 adult populations worldwide.

People over the age of 50 are at higher risk for developing the disorder.

  • What causes glossopharyngeal neuralgia?

Scientists believe that most cases of this neuralgia occur for no reason.

In some cases it can be occurred secondarily to some other circumstances like in one with head and neck masses, history of neck surgery or radiotherapy.

The following are susceptible to develop glossopharyngeal neuralgia:

Although it is rare for a mass to be the cause for this disorder, but if one has sharp and shooting pain attacks in the throat, especially if there is a vague, mild, low-intensity pain between attacks, then it would be necessary to evaluate carefully for any mass and tumor in brain and neck area.

 Glossopharyngeal neuralgia presents with unilateral pain in the base and back of the tongue, ear canal, and pharynx. The pain can be excruciating and continuous.

Some say that they have this pain many times during the day.

If you experience any of the following, further evaluation should be done to find out the exact cause of this problem:

  • If the symptoms are bilateral, ie. the person has a burning pain in both sides of the throat
  • Experience any sickness beside needle poking feeling in throat
  • If the symptoms doesn’t resolve completely and spontaneously.
  • Diagnosis

The process of evaluation to find out the exact cause of this disorder begins with complete history taking and full examination, especially brain and neck area.

In addition to the history and examination, you may be asked about any disease in your family and the list of drugs using or have used.

Further evaluation with direct pharyngeal examination, esophageal endoscopy, laryngoscopy or direct laryngeal observation and nasal endoscopy may be performed.

As mentioned above, because one of the causes of pain, especially bilateral pain and burning in the throat, can be tumors of the back of the nose and throat, so these tests are necessary:

  • Simple x-ray photo
  • CT Scan
  • M.R.I

Sometimes small vascular pressure on pharyngeal lingual nerve is seen on MRI images as the cause of this disorder.  

  • Treatment

Treatment of glossopharyngeal neuralgia is based on medical and interventional therapy. 

  • Medication:

The common medications used to treat glossopharyngeal neuralgia are as follow:


The first line of medical treatment is a medication called carbamazepine.

If you respond quickly to carbamazepine treatment, this prompt response may indicate that your doctor has made a correct diagnosis. glossopharyngeal neuralgia responds rapidly to carbamazepine.

Treatment with carbamazepine is usually started at a dose of 200 mg at bedtime and gradually increased by another 200 mg every two days If the pain improves or the drug reaches the maximum allowable daily dose of one thousand two hundred milligrams or severe side effects occur.

The important point in a person being treated with carbamazepine is that the person needs to be re-evaluated with a blood test and a blood cell count.

If abnormality in the complete blood cell count happens or skin lesions produces, the drug should be discontinued immediately.


In cases that carbamazepine cannot be used, another medication is used that is called gabapentin.

Proper dosage of gabapentin to treat glossopharyngeal neuralgia is 300 mg at bedtime.

It starts with the initial dose of 300 mg at bedtime and every two days 300 mg is added to the previous dose.

This process continues until either the drug reaches the maximum allowable daily dose of 1,800 mg or severe side effects occur.

When the pain improves, then the drug will be maintained and continued with the previous dose, for example, if a person’s pain improves with nine hundred mg per day, the drug will continue with the same dose.


If pain does not respond to carbamazepine and gabapentin or using these drugs are not suitable, then the third alternative is baclofen.

Treatment is started at the initial dose of 10 mg at bedtime.

Ten mg is added to the previous dose every five days until it reaches a maximum dose of 80 mg in twenty-four days or the pain improves or severe side effects occur.

In all of the above treatments, a complete biochemical blood cell count, a complete urine test, is required.

Previous tests are also necessary during the intermittent monitoring period of treatment.

  • Interventional therapies:

In some cases medical therapy fails to control the pain properly and additional treatment may be needed. Interventional therapies include the following:

  • Nerve block
  • Lingual pharyngeal nerve neurolysis


The first one is reversible but the neurolysis is irreversible.

The pharyngeal lingual nerve is known as the ninth nerve that emerges from the brain. This nerve, along with several other nerves like the Vagus nerve, the Accessory nerve, and internal jugular vein, exit from a hole in the floor and base of the skull called the jugular foramen and enters the lateral surface of the neck from the right and left.

Patients who are not completely relieved of their pain by nerve block are then considered for nerve neurolysis.

An anesthesiologist can perform lingual-throat neurolysis in two ways:


  1. Lingual pharyngeal neurolysis with radio frequency waves


  1. Lingual pharyngeal neurolysis with some drugs


It is usually recommended to use a combination of drug therapy in addition to interventional therapy in the treatment of severe and sudden attacks of glossopharyngeal neuralgia. The combination of these therapies always brings better results.


Cervical discopathy

Cervical disk problems can provoke lots of different pain and discomfort ranging from dull pain in neck to sharp shooting pain to fingertips.

Pain in cervical discopathy can be felt in throat and has needle like characteristics, but unlike glossopharyngeal neuralgia last longer and wouldn’t resolves completely on its own.




Inflammation of thyroid gland or thyroiditis can be painful. The characteristic of thyroiditis pain is that it exacerbates by swallowing and drinking.

Pain in thyroiditis can start suddenly but unlike glossopharyngeal neuralgia wouldn’t resolve spontaneously.


Take away

 What you feel in your throat is hard to understand by your doctor if you don’t describe it as detailed as possible. When see you physician try to explain you feeling as if present in one side or both side of your throat.

If you experience discomfort in your stomach or start new medication, don’t forget to tell your doctor about them.

Finding the exact cause of throat pain may become so tricky in some cases and needs lots of exams and images.



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